TY - JOUR
T1 - Second Autologous Stem Cell Transplantation as Salvage Therapy for Multiple Myeloma
T2 - Impact on Progression-Free and Overall Survival
AU - Jimenez-Zepeda, Victor H.
AU - Mikhael, Joseph
AU - Winter, Andrew
AU - Franke, Norman
AU - Masih-Khan, Esther
AU - Trudel, Suzanne
AU - Chen, Christine
AU - Kukreti, Vishal
AU - Reece, Donna E.
N1 - Funding Information:
Financial disclosure: The authors declare no competing financial interests. Jimenez-Zepeda V is a recipient of the MMRF Research fellow award.
PY - 2012/5
Y1 - 2012/5
N2 - The role of a second autologous stem cell transplant (ASCT) as salvage therapy is unclear, particularly with the availability of novel agents to treat progressive multiple myeloma (MM). We retrospectively reviewed all MM patients who received a second ASCT as salvage therapy at our center from March 1992 to December 2009. Eighty-one MM patients received a second ASCT for relapsed MM. The median time to relapse after first transplant was 39 months (9.83-100). All patients received reinduction therapy before the second ASCT. The high-dose regimen given before the second ASCT consisted of melphalan (MEL) alone in the majority. Complete response, very good partial response, and partial response were seen in 7.7%, 39.7%, and 50%, respectively, at day 100 post-ASCT; the median time to relapse after the second ASCT was 19 months. Early deaths occurred in 2.6%. Median progression-free survival (PFS) based on the time to myeloma relapse after first ASCT was 9.83 months (relapse ≤24 months) and 17.3 months (relapse ≥24 months) (P < .05). Median overall survival (OS) was 28.47 months (relapse ≤24 months) and 71.3 months (relapse >24 months) (P = .006). Second ASCT is a feasible and safe option for salvage therapy in MM. The best outcome was observed in patients whose time to progression was >24 months after first ASCT, as these patients had a subsequent PFS lasting over 1 year and an OS of almost 6 years.
AB - The role of a second autologous stem cell transplant (ASCT) as salvage therapy is unclear, particularly with the availability of novel agents to treat progressive multiple myeloma (MM). We retrospectively reviewed all MM patients who received a second ASCT as salvage therapy at our center from March 1992 to December 2009. Eighty-one MM patients received a second ASCT for relapsed MM. The median time to relapse after first transplant was 39 months (9.83-100). All patients received reinduction therapy before the second ASCT. The high-dose regimen given before the second ASCT consisted of melphalan (MEL) alone in the majority. Complete response, very good partial response, and partial response were seen in 7.7%, 39.7%, and 50%, respectively, at day 100 post-ASCT; the median time to relapse after the second ASCT was 19 months. Early deaths occurred in 2.6%. Median progression-free survival (PFS) based on the time to myeloma relapse after first ASCT was 9.83 months (relapse ≤24 months) and 17.3 months (relapse ≥24 months) (P < .05). Median overall survival (OS) was 28.47 months (relapse ≤24 months) and 71.3 months (relapse >24 months) (P = .006). Second ASCT is a feasible and safe option for salvage therapy in MM. The best outcome was observed in patients whose time to progression was >24 months after first ASCT, as these patients had a subsequent PFS lasting over 1 year and an OS of almost 6 years.
KW - Autologous stem cell transplant (ASCT)
KW - Multiple myeloma (MM)
KW - Overall survival (OS)
KW - Progression-free survival (PFS)
KW - Salvage therapy
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U2 - 10.1016/j.bbmt.2011.10.044
DO - 10.1016/j.bbmt.2011.10.044
M3 - Article
C2 - 22062804
AN - SCOPUS:84859851602
SN - 1083-8791
VL - 18
SP - 773
EP - 779
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 5
ER -